Understanding Wilms Tumor: Symptoms, Diagnosis, and Treatment Options

Wilms Tumor

Wilms Tumor

Cancer of the kidneys in children is known as Wilms' tumor. Wilms' tumor usually occurs in children under the age of five, with girls having a higher chance compared to boys. About 10% of patients with Wilms’ tumor have a recognizable phenotypic syndrome (including overgrowth disease, aniridia, genetic malformations, and others). These syndromes have provided clues to the genetic basis of the disease.

Though the exact cause is not known, Wilms' tumor occurs when cells in the kidneys fail to mature along with the fetus' development. These cells then multiply after birth and form the mass of cancerous, or malignant, cells that make up a Wilms' tumor.

Screening and diagnosis

The doctor will ask about signs and symptoms, other medical problems and the mother's pregnancy and also understand if there's a family history of cancer or congenital defects, particularly those of the genitals and urinary system.

The doctor will perform a physical examination and have laboratory tests of blood and urine done. Imaging tests are essential to help locate the tumor. This includes:

Ultrasound. This noninvasive technique uses sound waves to create images of organs.
Computerized tomography (CT). This imaging method uses X-rays to produce detailed, cross-sectional images of the body.
Magnetic resonance imaging (MRI). This approach uses a magnetic field and radio waves to create cross-sectional images of the body.

The doctor may order a chest X-ray, chest CT scan, chest MRI and bone scan to determine whether the cancer has spread beyond the kidneys.

Treatment of involves surgery to remove or reduce the size of the tumor.

BRIEF ABOUT THE PROCEDURE

Surgery

Surgical removal of kidney tissue is called nephrectomy. The various types of nephrectomy include:

Simple nephrectomy. In this surgery, the surgeon removes the entire kidney. The remaining kidney can increase its capacity and take over the entire job of filtering the blood.
Partial nephrectomy. This involves removal of the tumor and part of the kidney tissue surrounding it. It's usually performed when the other kidney is damaged or has already been removed.
Radical nephrectomy. In this type of surgery, doctors remove the kidney and surrounding tissues. Neighboring lymph nodes also may be removed.

At surgery, your child's doctor examines both kidneys and the abdominal cavity for any evidence of cancer. Samples from the kidney, lymph nodes and any tissues that appear abnormal are removed and examined by microscope to identify cancer cells.

A doctor specializing in pathology examines the tumor cells under a microscope and looks for features that indicate whether the cancer is aggressive or is susceptible to chemotherapy.

Chemotherapy

Chemotherapy uses medication to kill cancer cells, which could be administered in pill form or intravenous (IV) line or muscle injection.
Chemotherapy is considered systemic because it enters the bloodstream and travels throughout the body to destroy cancer cells wherever they may occur. It affects rapidly dividing cells; thus, normal cells with fast turnover — such as hair follicles, cells in the gastrointestinal tract and bone marrow, the tissue at the core of bone that manufactures blood cells — are affected as well as cancer cells. As a result, these medications can have the side effects of nausea, vomiting, loss of appetite, hair loss and low white blood cell counts. These side effects reduce after the drug is stopped, and some may lessen during therapy.
At high doses chemotherapy can destroy bone marrow. If high-dose chemotherapy is needed, the doctor may suggest that marrow be removed in advance and frozen and returned intravenously after chemotherapy (autologous bone marrow reinfusion).

Radiation therapy

Radiation therapy uses X-rays or other sources of high-energy rays to kill cancer cells. It's usually started within a few days after surgery. The radiologist will mark the area to be treated with a special dye at the same time shielding the other areas. Possible side effects include nausea, fatigue and skin irritation.

HOSPITALS FOR TREATMENT FOR WILMS TUMOR

DESTINATIONS FOR TREATMENT FOR WILMS TUMOR

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